scholarly journals Efficacy Assessment of One-Step Surgical Correction of Scoliotic Spine Deformity Using Cotrel-Dubousset Instrumentation

2004 ◽  
Vol 11 (4) ◽  
pp. 58-67 ◽  
Author(s):  
S T Vetrile ◽  
A A Kisel' ◽  
A A Kuleshov ◽  
S T Vetrile ◽  
A A Kisel' ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Deformity Correction ◽  
Treatment Quality ◽  
Spine Deformity ◽  
Score System ◽  
Scoliotic Deformity ◽  
Spine Mobility ◽  
Efficacy Assessment ◽  
One Step ◽  
Spine Fixation

In 50 patients with dysplastic scoliosis (mobile deformity of III-IV degree) that underwent dorsal correction and spine fixation using Cotrel-Dubousset the mean postoperative correction of primary arch was equal 59.8%. Instrumental correction exceeded natural spine mobility average by 1.5 times. No significant segmental vertebrae derotation after surgical treatment was obtained. Postoperatively correct anatomic correlations of body and disk height on convex and concave deformity sides were restored. In further it was the determinant factor in preserving of achieved correction. The score system for the assessment of surgical scoliotic deformity correction was suggested. It allows presenting complex standardized characteristic of surgical treatment quality.

Correction of Spine Pathology in Patients with Meningocele

2013 ◽  
Vol 20 (1) ◽  
pp. 46-52
Author(s):  
S. V Kolesov ◽  
A. N Baklanov ◽  
I. A Shavyrin
Keyword(s):  
Surgical Treatment ◽  
Life Quality ◽  
Deformity Correction ◽  
Vertebral Column Resection ◽  
Scoliotic Deformity ◽  
Average Curvature ◽  
Spine Instrumentation ◽  
Spine Deformities ◽  
Spine Pathology ◽  
Trunk Balance

Treatment results for 8 patients aged 3 to 17 years with neuromuscular spine deformities on the background of meningocele are presented. In all patients spine deformities were accompanied by spinal dysraphias. Average curvature arch was 86°. Surgical treatment was performed either in one (5patients) or in two (3 patients) steps. In 2 patients vertebral column resection (VCR) was performed. Average achieved scoliotic deformity correction made up62% and postoperative value of thoracic/thoracolumbar kyphosis approximated the physiologic one (40°). Surgical treatment of kyphoscoliosis on the background of meningocele that consisted of extensive spine instrumentation with pelvis fixation favoured the normalization of trunk balance, improved cardiopulmonary function, patients’ appearance and life quality. In this group of patients surgical intervention is associated with high intraoperative risk and rate of postoperative complications.

scholarly journals Surgical treatment of gross posttraumatic deformations in thoracic spine

2017 ◽  
Vol 5 (3) ◽  
pp. 80-86
Author(s):  
Aleksei E. Shul’ga ◽  
Vladimir V. Zaretskov ◽  
Galina A. Korshunova ◽  
Aleksei A. Smol'kin ◽  
Dmitrii Yu. Sumin
Keyword(s):  
Surgical Treatment ◽  
Thoracic Spine ◽  
Deformity Correction ◽  
High Energy ◽  
Fracture Dislocation ◽  
Spine Deformity ◽  
Surgical Trauma ◽  
Spine Stabilization ◽  
Spine Deformities ◽  
Post Traumatic

Rigid severe post-traumatic thoracic spine deformities result from frequent, recent high-energy trauma in children with an increasing frequency due to a variety of reasons. These types of injuries are commonly followed by spinal cord anatomic injury; therefore, the treatment of these patients warrants special attention from the ethical viewpoint. Generally, the only indication for surgical intervention is spinal dysfunction. Considering this and the patients’ ordinary severe somatic state, surgical trauma should be minimized as much as possible. However, for adequate deformity correction, effective spine stabilization and restoration of liquorodynamics is necessary. Recent studies have reported the successful use of different methods of dorsal interventions (P/VCR) in cases with unstable damages in children. Here, we present the case of a 15-year-old boy who underwent surgical treatment for coarse post-traumatic thoracic spine deformity with chronic fracture-dislocation of Th7 vertebra.

scholarly journals A method of reconstruction of female genitalia in girls with virilization

2014 ◽  
Vol 95 (3) ◽  
pp. 450-454 ◽  
Author(s):  
N R Akramov ◽  
A K Zakirov
Keyword(s):  
Surgical Treatment ◽  
Ambiguous Genitalia ◽  
Term Treatment ◽  
Urogenital Sinus ◽  
Basic Knowledge ◽  
Treatment Quality ◽  
Step Method ◽  
Self Identity ◽  
Long Term Treatment ◽  
One Step

The most common cause for female virilization is congenital adrenal hyperplasia. For anticipating the serious psychological distress related to ambiguous genitalia, these patients require plastic surgery. At present, two-step methods are preferred as more reliable. However, the surgical treatment in this case extends over several years, and can greatly affect patient’s psychosocial status. Based on the analysis of known surgical treatments, we proposed a one-step method of feminizing genitoplasty. The advantages of the proposed method allows one-step surgical treatment of girls with virilized genitalia at an earlier age, before the child reaches the period of sexual self-identity. This approach provides less psychosocial distress and reduces the number of interventions, maintaining the adequate sensitivity of the clitoris, providing moist and age-appropriate vaginal opening by using the preputium of the penis homolog and urogenital sinus mucosa at genitoplasty. The abovementioned advantages increases the surgical treatment quality and quality of life in girls with virilized genitalia. The method is reproducible by pediatric surgeons with basic knowledge of children’s anatomy. Yet, a lengthy follow-up is needed to assess the long-term treatment results.

scholarly journals PROBLEM OF SCOLIOTIC DEFORMITY MECHANICAL CORRECTION IN A SYSTEM OF CONSERVATIVE TREATMENT

2006 ◽  
pp. 033-039
Author(s):  
Mikhail Vitalyevich Mikhailovsky ◽  
Semyon Abramovich Shuts ◽  
Tatyana Nikiforovna Sadovaya
Keyword(s):  
Deformity Correction ◽  
Potential Effect ◽  
Spine Deformity ◽  
Active Force ◽  
Three Point Bending ◽  
Scoliotic Deformity ◽  
Different Types ◽  
Technical Principles ◽  
The Relationship ◽  
Effective Design

Objective – to determine parameters concerning the technical principles of brace design and methodical principles of brace treatment. A model of spine deformity correction is represented as a pattern of three-point bending of a beam. With regard to the trunk in a brace, this model presents the relationship between the active force and responces depending on active force location within the span between beam bearings. The influence of correcting forces locality factor on an issue of approach to deformity apex in different types of scoliosis is considered. Potential effect of different brace types is assessed. The problem questions of development of correction brace effective design are stated and variants of their solution are suggested. The force patterns of correction are discussed for some types of spine deformity.

scholarly journals COSTAL HUMPBACK RESECTION AS A FINAL STAGE OF IDIOPATHIC SCOLIOSIS SURGICAL TREATMENT

2006 ◽  
pp. 022-028
Author(s):  
Elena Vladimirovna Gubina ◽  
Mikhail Vitalyevich Mikhailovsky ◽  
Vladimir Nikolayevich Sarnadsky
Keyword(s):  
Surgical Treatment ◽  
Idiopathic Scoliosis ◽  
Vital Capacity ◽  
Deformity Correction ◽  
Spine Deformity ◽  
Curve Correction ◽  
Correction Loss ◽  
Group I ◽  
Curve Magnitude ◽  
Group Ii

Objective. To analyse results of multistage surgical treatment of idiopathic scoliosis including costal humpback resection. Material and Methods. From 1996 to 2005 twenty girls with idiopathic scoliosis underwent spine deformity correction with Harrington distraction rod with Drummond interspinous wires (Group I) or with Cotrel – Dubousset Horizon Instrumentation (Group II). The final long-dated stage after correction of deformity included the costal humpback resection at the convex side only. Radiologic and topographic examinations were performed, and lung vital capacity parameter was used for lung function assessment. Patients answered the Russian version of SRS-24 questionnaire after correction and at each follow-up examination. Results. In Group I the mean curvature was 81.7° ± 26.7° (range, 55–107°) before correction and 34.5° ± 13.1° after correction (primary curve correction 57.8 ± 14.1 %). Mean correction loss in dynamics before resection was 8°, after resection 4.3°. In Group II the primary curve magnitude before correction was 87.4° ± 27.1° (range, 48–126°), after correction 42.7° ± 16.9° (primary curve correction 51.9 ± 9.6 %). Average correction loss in dynamics before resection was 3.5°, after resection 2.4°. Spirometric findings presented the following dynamics: lung vital capacity before resection was 1980 ml with mean early postoperative decrease by 16.8 % and subsequent reversion to the preoperative level or increase to 2010 ml. According to the questionnaire survey 100 patients gave the consent for surgery. Conclusion. Costal humpback resection as a cosmetic intervention improves the patient’s assessment of spine deformity surgical correction result.

scholarly journals Outcome of surgical treatment by Harrington method different combinations in patients with scoliosis

1996 ◽  
Vol 3 (1) ◽  
pp. 3-6
Author(s):  
S. T. Vetrile ◽  
V. V. Shvets ◽  
A. A. Kuleshov
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Surgical Procedures ◽  
Postoperative Period ◽  
Deformity Correction ◽  
Scoliotic Deformity ◽  
Period 2

Authors analysed the outcomes of surgical treatment in 108 patients with scoliosis. Depending on surgical technique the patients were divided into 4 groups. The base of surgical procedures was different combinations of Harrington distractor with Luque rod as well as with segmental angular resection at the deformity apex. The efficacy of segmental angular resection that enabled to mobilize the rigid scoliotic deformity and increase intraoperative correction was detected. The combination of that procedure with the deformity correction by Harrington distractor and lateral traction by Luque rod allowed to achieve more marked correction and to preserve it to a greater degree and for longer time (2 years after operation 67,8% of achieved correction was preserved). It was also shown that fixation of corrective spine by Harrington distractor only did not provide considerable preservation of primary achieved correction in long term postoperative period (2 years after operation 47,3% of the achieved correction was preserved).

scholarly journals SURGICAL TREATMENT OF III–IV GRADE SCOLIOSIS WITH PLATE ENDOCORRECTOR

2006 ◽  
pp. 033-038
Author(s):  
Ravil Rafailovich Gatiatulin ◽  
Valentina Spiridonovna Lapinskaya ◽  
Vladimir Nikolayevich Shubkin ◽  
Timofey Viktorovich Frolyakin ◽  
Aleksandr Erikovich Kovalenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Three Dimensional ◽  
Deformity Correction ◽  
Third Generation ◽  
The Third ◽  
Scoliotic Deformity ◽  
Long Term Follow Up ◽  
Plate Breakage

Objectives. To analyze the efficacy of surgery using the original plate endocorrectors for III–IV grade idiopathic progressing scoliosis. Materials and methods. Two-plate endocorrector was used in surgical treatment of 380 patients. Out of them 171 patients at the age of 13–15 years had vertebral body apophysis ossification of stage 2–3 according to Risser’s test. Scoliosis was congenital in 12 patients (3.2 %) and idiopathic in 368 patients (96.8 %). The smallest coronal angle of curve according to Cobb was 40°, the largest one – 145°. Surgery of severe IV grade scoliotic deformity (curve angle of 60–90°) was performed in 178 patients. Results. Patients with non-removable instrumentation show the maintenance of post-surgical correction within 75–80% in long-term follow-up period (up to 9 years). Complications related to the plate endocorrector were observed in 9.8 % of cases: aseptic serous reaction induced by instability of the construct elements – in 3.7 %, plate breakage and release of endocorrector locking – in 5.3 %. Conclusion. Plate endocorrector of the third generation provides effective three-dimensional deformity correction for idiopathic III–IV grade scoliosis. The endocorrector does not prevent further spine growth in children after surgery.

Surgical Treatment of Scoliosis during the Period of Uncompleted Spine Growth

2010 ◽  
Vol 17 (1) ◽  
pp. 9-16
Author(s):  
A A Kuleshov ◽  
S T Vetrile ◽  
K G Zhestkov ◽  
V G Guseinov ◽  
M S Vetrile
Keyword(s):  
Surgical Treatment ◽  
Spine Deformity ◽  
Growth Step ◽  
Wedge Shape ◽  
Postoperative Spine ◽  
Asymmetric Growth ◽  
Vertebral Bodies ◽  
Deformity Progression ◽  
Spine Fixation ◽  
Dorsal Fixation

Outcomes of surgical treatment of 34 patients aged from 9 to 15 years (mean age 11.7 years) with basic curvature arch from 43 to 148° (99° average). In 9 patients dorsal correction and spine fixation by CD system without intervention on the vertebral bodies was performed (1st group). In 25 patients diskepiphysectomy (including thoracoscopic one in 7 patients) and interbody spondylodesis on the apex of the convex basic arch were performed prior to dorsal correction. Then halo-pelvic traction was performed for 7-10 days followed by dorsal fixation of the spine by CDI without posterior spondylodesis (2nd group). Subsequently depending on the degree of correction loss due to spine growth step-by-step corrections of the deformity were performed. After spine growth completion final instrumental correction and fixation of the spine with posterior spondylodesis were performed. In the 1st group step-by-step corrections were to be performed in 77% of cases, in 2nd group - in 28% only. It was shown that performance of diskepiphysectomy on the apex of the deformity with following correction and CD system fixation of the spine decreased the rate of postoperative spine deformity progression, eliminated asymmetric growth of vertebrae on the deformity and increased the achieved correction. In the process of patients' growth wedge shape of the vertebral bodies decreased in frontal and sagittal planes and no increase of their torsion-rotation changes occurred.

scholarly journals Outcome of scoliotic deformity correction with Harrington distractor in adults

1996 ◽  
Vol 3 (1) ◽  
pp. 6-9
Author(s):  
I. Z. Neiman ◽  
N. N. Pavlenko ◽  
Yu. G. Sumin ◽  
A. Ye. Kriger
Keyword(s):  
Surgical Treatment ◽  
Deformity Correction ◽  
Pain Syndrome ◽  
Complete Loss ◽  
Surgical Correction ◽  
Long Term Results ◽  
Initial Value ◽  
Preoperative Pain ◽  
Scoliotic Deformity

The results of surgical treatment of 36 patients with scoliosis, aged 18-29, were presented. Correction by Harrington distractor and posterior spondylosyndesis with allografts was performed. The average deformity correction achieved made up 38,8% of the initial value. Long term results (from 2 to 9 years) were studied in 29 patients. In 2 patients, complete loss of the correction was noted. In the rest of patients, the final correction varied from 9,9 to 49%, average 25,7%, of the initial value. The less is the scoliosis degree and age of a patient, the better is outcome of surgical correction. The preoperative pain syndrome being present in 7 patients was eliminated after operation.

Application of Cross-Section Corrective («Translation») Forces at Surgical Treatment for Scoliosis

2012 ◽  
Vol 19 (3) ◽  
pp. 14-19
Author(s):  
Ya. R Jalilov ◽  
V. Q Verdiyev ◽  
T. Y Jalilov
Keyword(s):  
Surgical Treatment ◽  
Cross Section ◽  
Deformity Correction ◽  
Stable Fixation ◽  
Loss Of Correction ◽  
Scoliotic Deformity ◽  
Mathematic Modeling ◽  
Long Term Follow Up

Surgical treatment results for 53 patients with III—IV stage of scoliosis are presented. In all patients original endocorrector has been applied. Endocorrector is based on the application of cross-section corrective («translation effect») forces that enable to shift the vertebrae of the main scoliotic arch to the median line of the trunk. Endocorrector was the most effective in curvature arch under 75° and provided 35—45° correction. Mathematic modeling of a situation «endocor- rector—curved spine» was performed as well as the pattern of forces created by endocorrector and participated in the scoliotic deformity correction was studied. Surgical intervention enabled to achieve stable fixation of the spine with its sagittal contours preservation. At long-term follow up (1—6 years) loss of correction did not exceed 8—10°. In scoliosis with arch over 75° step-by- step corrections were performed and loss of correction could make up 15°.

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